Ask Dr. H: Growing pains real but soon outgrown

Growing pains are real, but despite hundreds of years of observation, we're still not sure why they happen. We do know that the pains are completely harmless to your child.

The pain, located generally in the calves, thighs, shins or behind the knees, has nothing to do with growth of bones. The children most often affected by these nighttime pains are between the ages of 3 and 12, yet this is not the period of most rapid growth. If rapid bone growth was the cause of these pains, babies and toddlers would be crying every night as though they were in agony, and teenagers would be complaining of a whole lot of leg pain.

Babies grow anywhere from 6 to 10 inches in the first year of life; toddlers between 1 to 2 years of age grow 3 to 6 inches per year. In fact, the years when growing pains are at their worst occur when growth slows down. Mysteriously, the pain seems to disappear before puberty.

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Several criteria must be met before we can attribute the pain to "growing pain": (1) pain should occur in the late evening or during sleep (wakes the child up) only; (2) pain needs to be present for at least three months; (3) pain must occur in both legs; (4) there's never any joint pain, muscle weakness or redness or swelling; (5) there's no fever or weight loss; and (6) it's not present during or brought on by physical activities like running, riding a bike or other daytime play. If the pain is affecting only one leg and these criteria don't fit with your child's complaints, it's not growing pain, and serious diseases like juvenile rheumatoid arthritis or bone cancer must be considered.

What helps relieve growing pain? Massaging the muscles that hurt will help. Stretch out calf muscles and hamstrings every night, just as a jogger does. Advil or Tylenol also help. Extra calcium, potassium, and a multivitamin supplement are analogous to chicken soup - they couldn't hurt and they may help.

Fortunately, kids outgrow it within a year or so.

There are treatments for a retracted penis

Q:

I am writing to you about an embarrassing problem I've had for a number of years: I've "lost" my penis. I must sit to urinate just like a woman. I'm a 78-year-old man and have not been able to have sexual relations with a woman for a good number of years now. What caused this? Is there anything that could be done?

A:

It may comfort you to know that your problem of a retracted, buried penis is neither rare nor without treatment. Abdominal obesity and/or a low testosterone level are the usual causes for a retracted penis.

With obesity, an increase in the thickness of the fat pad above the scrotal area obscures the penile shaft. A low testosterone level causes atrophy of the genitalia and a subsequent buried penile shaft. The condition of a retracted, buried penis is made even worse with the inability to retract the foreskin of an uncircumcised individual due to "phimosis."

Treatment options include: (1) weight loss; (2) hormonal correction of a low testosterone level; (3) circumcision; and (4) surgery to remove excess pubic fat/skin and suture down the overlying skin of the pubis and scrotum to the base of the penile shaft. A urologist can evaluate your condition and recommend the best treatment option.

Mitchell Hecht is a physician specializing in internal medicine. Send questions to him at: "Ask Dr. H.," Box 767787, Atlanta, Ga. 30076. Due to the large volume of mail received, personal replies are not possible.